Health Care Ruling Brings Relief, Caution, Anger in Bluegrass State

Reaction is pouring in from all over the country following Thursday’s Supreme Court decision to uphold the federal health care law. To find out what the decision means for Kentucky, WKU Public Radio spoke with people from a variety of backgrounds to get a feel for the long-term ramifications for the Bluegrass State.

One of those people brings the perspective of both a doctor and a university official.

“As a physician, I’m very pleased," says Dr. David Dunn, the Executive Vice-President for Health Affairs at the University of Louisville. "This expands the scope of health care throughout the United States, and especially in the Commonwealth of Kentucky.”

Dunn says Americans should be pleased than an estimated 32 million people nationally who were previously uncovered will now access to health care.

However, Dunn cautions there are several key important questions that remain unresolved after the Supreme Court ruling. For example, where will we find all the physicians needed to treat those now eligible for care?

“In essence, we have a scenario where we have many more patients, maybe 300,000 to 400,000 more patients within Kentucky. These people will now have access to care, but they won’t be able to find a primary care physician or a nurse practicioner. So if you look at just Kentucky, we probably have a dearth of about 3,000 to 4,000 physicians," said Dr. Dunn.

For his part, Dunn would like to see greater federal funding for expanded residency training positions at American medical schools. He says the number of primary care physicians US schools are able to turn out was too low even before the federal health care law was passed.

“Typically, most teaching institutions—like the University of Louisville Medical School—are locked into training slot numbers dating back to 1996," he says. "With a provision of additional federal funding, we could open more slots, and train more doctors and midlevel providers, such as nurse practitioners.”

From a political standpoint, Kentucky has one of the most high-profile opponents of the federal health care law.

Mitch McConnell is Kentucky’s senior US Senator, and the highest-ranking Senate Republican. Following the Supreme Court’s decision, the Louisville Republican said if his party wins a majority of seats in the Senate this fall, he’ll make the repeal of the health care law the top GOP legislative priority.

Meanwhile, the American public’s view of the health care law has been a mixed bag according to polls.

On one hand, recent surveys have consistently shown at least a slight majority of respondents opposed the individual mandate portion of the law.

However, solid majorities supported other key parts of the Affordable Care Act, such as a portion that prohibits insurance companies from refusing to take on those with certain pre-existing conditions. And WKU Professor of Healthcare Administration Gregory Ellis-Griffith says a part of the law that allows young people to stay on their parent’s insurance plans has widespread support in Kentucky and throughout the nation.

“That is huge," said Ellis-Griffith. "We have a lot of college students that are coming out and, because of the economy, are having a hard time finding jobs, or they’re finding jobs that are barely supporting them and don’t have benefits. But now you can stay on your parents’ health insurance plan until you’re 26.”

As a result of the law, an estimated 35,000 Kentuckians under the age of 26 now have insurance on their parents’ health care plans.

The Supreme Court ruling upholding the health care law surprised many observers who thought Chief Justice John Roberts would vote to strike down the act. Instead, he wrote the majority opinion supporting the President’s plan.

WKU History Professor and constitutional law expert Patricia Minter says Roberts was comfortable with the idea that Congress can tax citizens, as in the case of penalizing someone who doesn’t buy his or her own health insurance…

“And in doing that, he cites Steward Machine Company vs. Davis, which is a 1937 case that the Supreme Court used to uphold the Social Security Act," said Minter.

Professor Minter says this health care law ruling will now serve as the final lecture for her next legal history class.

She says love it or hate it, the Court’s decision will likely be studied for years to come for what it says about the rights of government and individuals.